| NPI | 1790336519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: KS 79036) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: MO 2019033532) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2023-06-09 |